Introducer Sheath Stabilizer

ABSTRACT

A device for introducing an embolic coil into a catheter comprises an elongated body defining a longitudinal passage extending therethrough from a first opening at a proximal end thereof to a second opening at a distal end thereof, the elongated body being including a mating portion for conforming to a size and shape of an opening in a hub of a catheter to mate therewith and an embolic coil introducer sheath including a coil receiving lumen extending therethrough, a distal tip of the introducer sheath being dimensioned to be received within a proximal end of the longitudinal passage. Similarly, a method of implanting an embolic coil, comprises inserting a stabilizer into a catheter hub so that a flexible mating portion substantially conforms to a shape of an inner surface of the hub wherein the stabilizer includes a passage extending therethrough from a proximal opening to a distal opening thereof. An introducer sheath including an embolic coil received in a lumen thereof is inserted into the proximal opening of the passage and through the passage to exit the distal opening thereof so that a distal opening of the lumen is positioned substantially adjacent to a proximal opening of a catheter and an embolic coil is advanced out of the distal opening of the lumen into the catheter and deployed in the body through the catheter.

BACKGROUND OF THE INVENTION

Embolic coils have been used to stop undesired blood flow, as in, forexample, the treatment of aneurysms, arteriovenous malformations,traumatic fistulae and in tumor embolization. These conditions requirethat the blood flow through a portion of a blood vessel be stopped, forexample by introducing an artificial device into the vessel to slow theflow, and by letting the natural clotting process form a more completeblockage of the blood vessel with a clot.

Embolic coils can be used to form a blockage in a vein or artery totreat conditions like those listed above. These devices have becomeincreasingly common in procedures to block the flow of blood bypromoting formation of a clot in a desired location. Embolic coils aremade from a bio-compatible material, such as platinum, to minimize theproblems associated with tissue irritation and rejection. These coilsare often shaped as complex three dimensional curves that fill inportions of the blood vessels and slow blood flow therein. Often,polymeric fibers are added to the metallic coils to enhance the coil'sthrombogenicity, which is the coil's ability to promote formation ofclots.

Embolic coils are typically introduced into a blood vessel by using amicrocatheter which extends from a proximal point outside the patient'sbody to a distal point near the embolization site. An introducer sheathcontaining the coil is used to carry and protect the coil prior toinsertion into the patient, and also to transfer the coil to themicrocatheter. From the introducer sheath the coil is pushed into themicrocatheter and navigated to the embolization site, where it isdeployed from the microcatheter. It is often beneficial to pre-hydratethe coil before insertion into the microcatheter to lubricate the coil,so that it travels more easily to the embolization site. In addition,the fluid used to lubricate the coil may be medicated to increase thethrombogenic properties of the coil, reduce infections, or to addressother needs.

SUMMARY OF THE INVENTION

In one aspect, the present invention is directed to a device forintroducing an embolic coil into a catheter comprising an elongated bodydefining a longitudinal passage extending therethrough from a firstopening at a proximal end thereof to a second opening at a distal endthereof, the elongated body being including a mating portion forconforming to a size and shape of an opening in a hub of a catheter tomate therewith in combination with an embolic coil introducer sheathincluding a coil receiving lumen extending therethrough, a distal tip ofthe introducer sheath being dimensioned to be received within a proximalend of the longitudinal passage.

The present invention is further directed to a method of implanting anembolic coil, comprising inserting a stabilizer into a catheter hub sothat a flexible mating portion substantially conforms to a shape of aninner surface of the hub, the stabilizer including a passage extendingtherethrough from a proximal opening to a distal opening thereof andinserting an introducer sheath including an embolic coil received in alumen thereof into the proximal opening of the passage and through thepassage to exit the distal opening thereof so that a distal opening ofthe lumen is positioned substantially adjacent to a proximal opening ofa catheter. The embolic coil is advanced out of the distal opening ofthe introducer sheath lumen into the catheter and deployed in the bodyvia the catheter.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a schematic side elevation view showing an introducer sheathstabilizer, according to the present invention, disposed in amicrocatheter hub;

FIG. 2 is an exploded side elevation view of an introducer sheathstabilizer, according to the present invention;

FIG. 3 is a perspective view of the introducer sheath stabilizer of FIG.2;

FIG. 4 is a schematic side elevation view of an introducer sheathstabilizer used in a coil pre-hydration function;

FIG. 5 is a schematic side elevation view of an introducer sheathstabilizer used in a coil introduction function;

FIG. 6 is an exploded view showing another embodiment of an introducersheath stabilizer, according to the present invention, incorporated intoan assembly having aspects of a rotating hemostasis valve (RHV); and

FIG. 7 is an assembled view of the introducer sheath stabilizer of FIG.6.

DETAILED DESCRIPTION

The present invention may be further understood with reference to thefollowing description and the appended drawings, wherein like elementsare referred to with the same reference numerals. The present inventionis related to medical devices used to introduce an embolic coil into thevascular system of a patient. More specifically, the invention isrelated to devices used to introduce an embolic coil using a catheter,and to hydrate the embolic coil prior to deployment.

Embolic coils have been widely used to treat medical conditionsrequiring the disruption of the blood flow to specific regions of thebody. For example, the treatment of aneurysm, arterial or venousmalformations, traumatic fistulae and tumor embolization requires thatthe supply of blood to the affected areas be interrupted. Aneurysmsoccur when a portion of an artery's wall becomes weakened and expands ina balloon-like manner. As more blood flows in, the aneurysm continues toexpand and the wall of that portion becomes stretched and thins. If thewall at the aneurysm expands too much, it may burst and cause ahemorrhage. This is a very dangerous condition which may lead to death,coma, paralysis, or other serious medical condition when it occurs inthe brain or another vital organ.

Traditionally, this condition has been very difficult to diagnose, sincepatients are generally asymptomatic until the aneurysm bursts. At thatpoint, most of the damage has already taken place, and the availablemedical therapies are limited. Even where the aneurysm is identifiedprior to bursting, medical options have been limited because aneurysmsare often in locations that are difficult to reach by surgery andrepairing the damaged blood vessel may be impossible. Recent advances invisualization methods, however, have made the early identification ofaneurysms and similar problems more common. Once an aneurysm has beenlocated, it may be possible to block the supply of blood thereto via anembolic coil, even if surgery to repair the blood vessel is notpractical.

Embolic coils may also be used successfully in the treatment of varioustypes of cancer. As tumors often require a large supply of blood togrow, it may be possible to impede further growth by restricting oreliminating this blood supply. Embolic coils may be deployed to shutdown blood vessels alimenting the tumor to kill or limit the growth ofthe malignancy. Deployment of the coil may be aided by variousvisualization methods, to ensure correct positioning and to evaluate theefficacy of the treatment. The treatment of traumatic bleeding may alsobenefit from the use of embolic coils. As would be understood by thoseskilled in the art, damage to blood vessels causing significant bloodloss may result in death or a critical condition. This may be especiallyserious when the injury is internal and the bleeding cannot becontrolled without resorting to complex surgical procedures. Emboliccoils may be employed to reduce or stop the hemorrhage by blocking theveins or arteries leading to the damaged area(s).

The deployment of embolic coils into a patient's vascular system istypically carried out using a catheter. The distal end of the catheteris inserted into a blood vessel and is navigated to the site where thecoil is to be deployed with any of various methods of visualizationbeing employed to confirm that a distal end of the catheter ispositioned at the proper location. The catheter may be a microcatheter,having a catheter hub at the proximal end which remains outside of thebody during the procedure. The embolic coil may be held in an introducersheath for manipulation prior to insertion, and to insert the coil intothe microcatheter after the coil has been prepared.

Introducer sheaths can be difficult to insert into the catheter hub atthe microcatheter's proximal end. The microcatheter hub is a deviceadapted to receive attachments to the proximal end of the catheter. Ifthe introducer sheath tip is not fully pressed into the catheter hubduring coil delivery, or if there is a space between the sheath tip andthe lumen of the microcatheter, the coil may be deployed in the hubcausing premature detachment or jamming. For example, interlockingdetachable coils feature a coil connected to a drive mechanism, fromwhich it detaches when it is ejected from the catheter. If theintroducer sheath is not seated fully in the catheter hub, the arms ofthe drive mechanism can detach prematurely and cause jamming in the hub.It is thus important to ensure that the coil is passed directly into thecatheter lumen from the introducer sheath.

As described above, prior to insertion in the catheter, it is oftennecessary to pre-hydrate the coil. This preparatory step consists ofirrigating the coil with a saline solution which may contain one or moremedical compounds. For example, the coil may be irrigated with a heparinsolution to prevent premature coil thrombosis prior to desired finaldeployment of the coil. Other fluids may also be used to hydrate theembolic coil. For example, compounds adapted to lubricate the coil as ittravels through the microcatheter may be used, as well as disinfectingcompounds, if needed.

Conventionally, pre-hydration of the embolic coil is carried out beforeinsertion in the catheter, while the coil is still held in theintroducer sheath which can be difficult. However, if the embolic coilis removed from the introducer sheath for pre-hydration, the coil maykink or be deformed when replaced in the introducer sheath. Inparticular, coils that comprise fibers extending from the coil loops maybenefit from being pre-hydrated without removal from the introducersheath. The fibers are designed to further reduce the flow of bloodaround the coil, and have a predetermined orientation. Deploying andthen re-sheathing these fibered coils for pre-hydration may reverse thedirection and change the orientation of the fiber bundles, reducingtheir effectiveness.

According to embodiments of the present invention, an introducer sheathstabilizer may be used for both facilitating pre-hydration of an emboliccoil and to simplify transfer of the coil from the introducer sheath toa microcatheter. During both steps, the embolic coil is protected fromdamage. The procedure may be carried out by a single physician, withoutthe need for involvement of assistants. FIG. 1 shows an exemplaryembodiment of an introducer sheath stabilizer according to theinvention. In the drawing, a sheath stabilizer 100 is shown in anoperative position within a hub 202 of a microcatheter 200. A distal end102 of the stabilizer 100 is inserted into the hub 202 of themicrocatheter 200, such that it abuts the proximal end of a catheterlumen 204.

During use, an introducer sheath 216 containing an embolic coil 214 isinserted into the proximal end 104 of the stabilizer 100, and is pushedthrough the stabilizer 100 until it exits out of the distal end 102 ofthe stabilizer 100, as clearly shown in FIGS. 4 and 5. The introducersheath 216 is then further pushed until it contacts the proximal end ofthe lumen 204. In this manner the stabilizer 100 helps to maintain theintroducer sheath 216 in place preventing premature coil detachment andjamming of the coil 214 in the catheter hub 202. In the exemplaryembodiment, the stabilizer 100 comprises slits 106 formed longitudinallyon the walls thereof. The slits 106 facilitate the insertion of theintroducer sheath 216 into the stabilizer 100, prior to attachment tothe catheter hub 202, and also provide a better connection with thecatheter hub 202. In this example, the stabilizer 100 mechanically andfrictionally cooperates with the hub 202 to properly position theintroducer sheath 216.

As will be described below in more detail, the sheath introducer thestabilizer 100 may also be used to facilitate pre-irrigation of theembolic coil 214 prior to deployment. In this function, the stabilizer100 is used to couple a syringe or other source of irrigating fluid tothe introducer sheath 216 containing the embolic coil 214. Thestabilizer 100 thus serves a dual function, facilitating thepre-irrigation of the coil and the insertion of the coil 214 into themicrocatheter 200. The physician performing the embolization procedurethus can carry out two tasks using only one device which can beprovided, for example, together with the introducer sheath 216 as partof the packaging for the embolic coil 214.

FIGS. 2 and 3 show an exemplary embodiment of the stabilizer 100according to the invention. In this embodiment, the stabilizer 100comprises two portions joined to one another. A rigid female lueradapter 112 forms the proximal end 104 of the stabilizer 100 and isdesigned to provide a means of connecting the stabilizer 100 to anotherdevice provided with a luer. A flexible conical section 110 defines thedistal portion 102 and completes the stabilizer 100. The flexibleconical section 110 is designed to provide a snug fit with the proximalend of the microcatheter, such as by acting as an adapter fitting intothe catheter hub 202. However, the stabilizer 100 may also be used tofacilitate pre-hydration of the embolic coil 214 while still in theintroducer sheath 216. In that function, the distal end 102 of theflexible conical section 110 becomes a receptacle for the distal tip ofthe introducer sheath 216. A syringe may then be connected to the lueradapter 112 to provide the irrigation.

As would be understood by those skilled in the art, the rigid femaleluer adapter 112 may be formed of any suitable material compatible withconventional luers (for example, polycarbonate, ABS plastic, Tecoplast).As would be understood, the material selected should be sufficientlyresilient to maintain the dimensions of the luer adapter 112 during useof the stabilizer 100. A lumen 118 extends longitudinally through theluer adapter 112, and joins a lumen 118′ which extends through theflexible conical section 110 to form a continuous passage through thestabilizer 100. The lumens 118, 118′ have dimensions adapted to receivethe introducer sheath 216 therethrough. The flexible conical section 110may be formed from polyurethane, santoprene, silicone, natural latex,other thermoplastic elastomers or any material having a suitableflexibility.

In one embodiment, slits or openings 106 may be formed on shell-likewalls of the conical section 110, to provide additional flexibility. Theflexibility of the conical section 110 enables the stabilizer 100 to fitsecurely in a variety of catheter hubs having different dimensions, toprovide a secure and stable interface between the catheter hub and theintroducer sheath 216. In particular, the slitted portion of theflexible conical section 110 allows it to expand and/or contract to fitcatheter hubs of different diameters. According to exemplary embodimentsof the invention, the flexible conical section 110 forms a catheter hubadapter having outer surfaces which substantially match an inner passageof the hub, and which form a frictional and mechanical connection to thehub. As can be seen in the figures, a radius of the conical section 110is a minimum at the distal end 102 and a maximum at the proximal end104, so that conical section 110 can be inserted into the hub until theconnection is made.

The exemplary flexible conical section 110 comprises a distal opening114 with a sealing device, which may be a valve 120. The valve 120 maybe of a single slit design, as shown, or may be a dual slit or multislit design. The valve 120 is designed to accept the coil introducersheath 216 for pre-hydration of the embolic coil 214 contained therein.In this mode, the tip of the introducer sheath 216 is inserted from theoutside into the conical section 110 through the valve 120 which forms aseal around the introducer sheath 216. Conversely, when the stabilizer100 is used to facilitate the introduction of the embolic coil 214 intothe catheter 200, the distal tip 206 of the introducer sheath 216 isinserted through a proximal opening 116 of the stabilizer 100 and pushedout of the stabilizer 100 through the valve 120. The valve 120 thuspermits passage of the introducer sheath 216 in both directions, whileproviding a sealing action around exterior surfaces of the introducersheath 216.

The coil pre-hydration function of the stabilizer 100 is described ingreater detail with reference to FIG. 4. As shown, an embolic coil 214is contained within a tubular passage 218 extending through the sheath216 from a proximal coil receiving opening to a distal coil deployingopening formed in a distal end 206 thereof. In this configuration, theembolic coil 214 is ready for deployment. However, if it is desired topre-hydrate the coil 214, this may be done without removing the coil 214from the passage 218. According to the invention, the distal tip 206 ofthe introducer sheath 216 is inserted into the stabilizer 100 via theopening 114 of the distal end 102 so that the distal tip 206 is receivedwithin the stabilizer 100 with the distal opening facing the proximalopening 116 in the luer adapter 112. The valve 120 provides a sealaround the outer surface of the introducer sheath 216, such that a fluidmay flow within the lumen 118 to the passage 218 without leaking fromthe stabilizer 100. A syringe 210 or other similar source of hydratingfluid is connected to the luer adapter 112 using a conventional luerattachment, such that the nozzle 212 enters the proximal opening 116 ofthe stabilizer 100. Fluid such as, for example, a heparinized solution,is then injected into the lumen 118 of the stabilizer 100 from thesyringe 210 into the passage 218 of the introducer sheath 216, to reachthe coil 214.

After pre-hydration, the stabilizer 100 may be used to assist inintroducing the coil 214 into a microcatheter 200 via the coil deployingopening in the distal end 206. To use the stabilizer 100 in this way,the syringe 210 is disconnected from the stabilizer 100 and the sheath216 is removed from the stabilizer 100 and reinserted into thestabilizer 100 via the opening 116 at the proximal end thereof. Thesheath 216 is extended through the valve 120 so that the distal tip 206protrudes from the distal end of the stabilizer 100.

The coil introduction function of introducer sheath stabilizer 100 isdescribed in more detail with reference to FIG. 5. In thisconfiguration, the smaller diameter distal end of the cone-shapedstabilizer 100 is inserted into the catheter hub 302 of a catheter 300.The flexible conical section 110 is formed of a pliable material to matewith a tapered inner surface 303 of the catheter hub 302 to form astable, temporary frictional and mechanical connection with the catheter300. The introducer sheath 216 is then inserted into the stabilizer 100through the proximal opening 116 and is pushed through the passage 118until its distal end 206 emerges from the distal opening 114 through thevalve 120. The introducer sheath 216 is further pushed longitudinallyuntil the coil deploying opening of the distal tip 206 seats in thetapered inner surface 303 substantially adjacent to a proximal openingof the catheter lumen 304. Thus, the coil 214 may be transferreddirectly from the passage 218 to the lumen 304 without unwanted movementof the tip 206 relative to seating surfaces of the catheter hub 302.This reduces the chances of premature detachment, damage or entrapmentof the coil 214 in the microcatheter hub 302.

The exemplary multi functional introducer sheath stabilizer according toembodiments of the present invention allows for embolic coilpre-hydration without removal from the sheath as well as greater ease ofcoil insertion in a delivery catheter, by using a single device. Theexemplary device may be used for multiple types of coils, includingpushable coils and fibered coils for which pre-deployment andre-sheathing risk reversing or altering the fiber's orientation. Theinclusion of a luer adapter allows for in line attachment of a rotatinghemostatic valve (RHV) for continuous or intermittent heparinized salineflush of the microcatheter lumen.

In a different exemplary embodiment, the introducer sheath stabilizermay be incorporated into an RHV. FIGS. 6 and 7 show a stabilizer 400adapted to fit in an RHV placed on the proximal end of a microcatheter300. In this configuration, a distal male luer 406 is adapted to lock tothe proximal end of a catheter hub 302 of the microcatheter 300. Thedistal male luer 402 doubles as a valve housing and serves as the bottomvalve housing for a valve 402. The valve 402 may be a conventional valveused in conjunction with catheters. The stabilizer 400 fits through apassage 408 which extends through the valve 402 and through the malevalve housing 406 and further extends beyond the RHV to protrude intothe microcatheter hub 302. The distal end 410 of the stabilizer 400protrudes sufficiently to engage the tapered portion 301 of the hub 302and thus seal against any reflux of blood or other fluids from themicrocatheter 300. A threaded closure may be used to join the male valvehousing 406 to a female luer adapter 404, which allows mating to anexternal device for flushing the microcatheter 300 prior to introducingthe coil 214 thereinto.

The assembly of the male valve housing 406 and the female luer adapter404 forms a structure which contains the valve 402 and defines a passage408 containing the stabilizer 400. The assembly may be designed so thatthe valve 402 can be closed by the user, for example by tightening thethreads of the assembly. Placing the stabilizer 400 within the RHVprovides several advantages. Seating the stabilizer 400 in themicrocatheter hub 302 helps prevent the occurrence of retrograde bloodflow up the sheath 216 reducing the possibility of thrombus build up inthe interface between the two parts and reducing friction in the sheath216. As in the embodiments described above, the stabilizer 400 maintainsthe introducer sheath 216 (not shown in FIG. 6) centered within themicrocatheter hub 302, resulting in a smoother introduction of theembolic coil 214 into the microcatheter 300. The valve 402 preventskickback of the sheath 216 and together with the stabilizer 400 reducescoil jamming and premature detachment.

As described above, the distal portion of the sheath 216 may be formedof a compressible material adapted to conform to the inner surfaces of avariety of microcatheter hubs. This universal compatibility of thestabilizer 400 with different catheters and hubs may be enhanced byslots 412 formed in the conical portion of the stabilizer 400. The slots412 help the proximal portion of the stabilizer 400 to widen or narrowto fit different size passages, so that the stabilizer 400 provides aproperly sized passage to an introducer sheath 216 containing a coil 214regardless of the size of the catheter or hub.

The present invention has been described with reference to specificembodiments, and more specifically to a stabilizer used to facilitateintroduction of an embolic coil into a microcatheter hub. However, otherembodiments may be devised that are applicable to other procedures anddevices, without departing from the scope of the invention. Accordingly,various modifications and changes may be made to the embodiments,without departing from the broadest spirit and scope of the presentinvention as set forth in the claims that follow. The specification anddrawings are accordingly to be regarded in an illustrative rather thanrestrictive sense.

1-21. (canceled)
 22. A system for introduction of a coil into a catheterfor deployment into a body lumen, comprising: a stabilizer including arigid luer adapter at a proximal end thereof and a flexible catheter hubmating portion extending from the luer adapter to a distal end of thestabilizer wherein a passage extends through the stabilizer from theproximal end to an opening formed in the distal end; and an introducersheath including a coil receiving lumen extending therethrough to a coildeploying opening, a distal portion of the sheath being sized forinsertion through the passage to project distally from the distalopening, the distal portion of the sheath and the mating portion beingsized so that, when the mating portion is inserted to an operativeposition within a hub of a catheter with the distal portion of thesheath projecting therefrom, the coil deploying opening abuts a proximalopening of the catheter.
 23. The system according to claim 22, furthercomprises: a valve to seal the passage around the sheath.
 24. The systemaccording to claim 23, wherein the valve comprises a membrane with atleast one slit formed therein.
 25. The system according to claim 22,wherein an outer surface of the mating portion is shaped substantiallysimilarly to an inner surface of the catheter hub.
 26. The systemaccording to claim 25, wherein the outer surface of the mating portionis substantially conical.
 27. The system according to claim 22, whereinthe mating portion includes a plurality of slits imparting increasedflexibility thereto.
 28. The stabilizer according to claim 22, wherein aminimum radius section of the mating portion is adjacent to the distalend of the stabilizer and a maximum radius thereof is adjacent to theluer adapter.
 29. The stabilizer according to claim 22, wherein, wheninserted into a hub of a catheter, the mating portion frictionally andmechanically engages the hub to retain a desired relative position ofthe sheath and the catheter during introduction of an coil thereto. 30.The stabilizer according to claim 22, wherein the rigid luer adapter andthe mating portion are frictionally joined.
 31. A method for implantingan embolic coil, comprising: inserting a stabilizer into a catheter hubso that a flexible mating portion substantially conforms to a shape ofan inner surface of the hub, the stabilizer including a passageextending therethrough from a proximal opening to a distal openingthereof; inserting an introducer sheath including an embolic coilreceived in a lumen thereof into the proximal opening of the passage andthrough the passage to exit the distal opening thereof so that a distalopening of the lumen is positioned substantially adjacent to a proximalopening of a catheter; advancing the embolic coil out of the distalopening of the lumen into the catheter; and deploying the embolic coilin the body via the catheter.
 32. The method according to claim 31,wherein the introducer sheath includes a valve sealing the distalopening thereof, the method further comprising: prior to inserting thestabilizer into the catheter hub, inserting the introducer sheath intothe passage through the valve sealing the distal opening; and injectinga pre-hydrating solution into the stabilizer to pre-hydrate the coil.33. The method according to claim 31, wherein when inserted into thecatheter hub, the stabilizer mechanically and frictionally engages thecatheter hub.
 34. A system for introduction of a coil into a catheterfor deployment into a body lumen, comprising: a stabilizer including aproximal opening, a distal opening, and a passage extendingtherethrough; a valve including a male luer, a distal end of thestabilizer being inserted through a passage of the valve; a female lueradapter having a passage for receiving a proximal end of the stabilizer,wherein the valve and the female luer are coupled to each other to forma structure; an introducer sheath including a coil receiving lumenextending therethrough to a coil deploying opening, a distal portion ofthe sheath being sized for insertion through the passage of thestabilizer to project distally from the distal opening; and a catheterhub including a passage, wherein the valve is coupled to a proximalportion of the catheter hub, and wherein the stabilizer extends from thevalve into the passage of the catheter hub for a distance sufficient toform a seal with a surface of the passage of the catheter hub.
 35. Thesystem as recited in claim 34, wherein the passage of the catheter hubincludes a tapered portion at which the seal with the stabilizer isformed.
 36. The system as recited in claim 34, wherein the valve isrotatably engaged with the female luer.
 37. The system as recited inclaim 36, wherein the valve is closed by rotating the structure in afirst direction.
 38. The system as recited in claim 34, wherein thedistal portion of the introducer sheath and a distal portion of thestabilizer are sized so that, when the distal portion of the stabilizeris inserted to an operative position within the catheter hub with thedistal portion of the introducer sheath projecting therefrom, the coildeploying opening abuts a proximal opening of a catheter joined to thecatheter hub.
 39. The system as recited in claim 34, wherein the distalportion of the introducer sheath includes a compressible material. 40.The system as recited in claim 34, wherein the stabilizer includes aconical surface provided with a plurality of slots.
 41. The system asrecited in claim 34, wherein the distal opening of the stabilizercomprises a slit membrane to seal the passage of the stabilizer aroundthe introducer sheath.